Obituaries

Maria Takacs
B: 1927-09-28
D: 2018-09-13
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Takacs, Maria
Charles Garland
B: 1928-07-03
D: 2017-09-16
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Garland, Charles
William Edge
B: 1926-06-21
D: 2017-09-13
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Edge, William
Kyle Whaley
B: 1991-12-03
D: 2017-09-13
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Whaley, Kyle
Gerald Levine
B: 1931-10-16
D: 2017-09-10
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Levine, Gerald
Gerald Cavanaugh
B: 1934-06-05
D: 2017-09-06
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Cavanaugh, Gerald
Miriam Major
B: 1939-05-25
D: 2017-09-05
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Major, Miriam
Richard Waite
B: 1944-12-08
D: 2017-09-05
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Waite, Richard
Claire Brown
B: 1940-06-26
D: 2017-09-04
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Brown, Claire
Katherine Dutilly
B: 1931-05-02
D: 2017-09-03
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Dutilly, Katherine
Herbert Stein
B: 1924-12-16
D: 2017-08-30
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Stein, Herbert
Edward Beckman
B: 1931-12-28
D: 2017-08-26
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Beckman, Edward
Joseph Lorusso
B: 1946-08-20
D: 2017-08-24
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Lorusso, Joseph
Constantino Napase
B: 1950-03-11
D: 2017-08-22
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Napase, Constantino
Mary Forney
B: 1919-11-21
D: 2017-08-17
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Forney, Mary
Robert Sansone
B: 1937-04-30
D: 2017-08-14
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Sansone, Robert
Tieng Le
B: 1939-05-30
D: 2017-08-14
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Le, Tieng
Arlene Tiddens
B: 1928-02-28
D: 2017-08-11
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Tiddens, Arlene
Claudia Antonucci
B: 1943-04-11
D: 2017-08-10
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Antonucci, Claudia
James Bugniazet
B: 1938-01-06
D: 2017-08-10
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Bugniazet, James
Lois Lerman
B: 1948-07-13
D: 2017-08-08
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Lerman, Lois

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10055 Heritage Farms Rd
Lake Worth, FL 33449
Phone: (561) 967-1200
Fax: (561) 967-1444

Immediate Need

First, let us say that we are so sorry for your loss.

To report a death to Palm Beach National Chapel, please notify us first by phone at (561) 967-1200.

After that call, we will take your loved one into our care and will confirm a time/date for the arrangement conference. If you would prefer to expedite your time with our staff during that arrangement process, you may enter your loved one's basic information in this form below.


I. Informant Information

Full Name of Informant:
Relationship to Deceased:
Informant's Phone Number:
Informant's Email Address:

II. Decedent's Biographical Information

Full Name of Decedent:
Date of Death:
Decedent's Address:
City Name:
State:
Zip Code:
Telephone Number:
Date of Birth:
City of Birth:
State of Birth:
Highest Education Level:
Father's Name:
Father's City of Residence:
Mother's Name:
Mother's City of Residence:
Mother's Maiden Name:
Spouse's Name:
Spouse's Maiden Name:
Survivors' Names/Residence
Preceded Relatives
Occupation:
Industry:
Employer's Name:
Church Membership:
Club Affiliations:

III. Decedent's Military Record

Veteran:
Branch of Service:
Serial Number:
Date Enlisted:
Date of Discharge:
Rank at Discharge:
Time of Military Service:
Military Honors at Graveside:
Flag Preference for Service:

III. Service Preferences

Type of Service:
Visitation Hours:
Casket:
Officiating Clergy:
Pallbearers:
Flower Preference:
Music Selection:
Jewelry:
Glasses:
Casket Preference:
Disposition:
Cemetery Name:
Cemetery Location:

Miscellaneous Notes and Instructions:


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